The Orthopaedic Hospital of Lutheran Health Networ

7952 W Jefferson Blvd, Ft Wayne, IN 46804 · (260) 435-2999

Acute Care HospitalsProprietaryFort Wayne, IN metro Website ↗

Price file

Prices published

File dated 2026-04-01

63,709 price rows for 65 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 6 lines · metro median $7

cash

$3 to $243

502 negotiated rates

$27

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 12 lines · metro median $1,470

$2,884

cash

$327 to $10,680

642 negotiated rates

$10,680

list

CT scan of the head, no contrast

CPT 70450 · lowest of 6 lines · metro median $541

$888

cash

$98 to $3,288

428 negotiated rates

$3,288

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 6 lines · metro median $764

$1,283

cash

$164 to $4,750

321 negotiated rates

$4,750

list

Cataract surgery with lens implant

CPT 66984 · lowest of 8 lines · metro median $501

$501

cash

$443 to $10,034

728 negotiated rates

$1,854

list

Cesarean delivery with prenatal and postpartum care

CPT 59510 · lowest of 2 lines · metro median $1,578

$1,578

cash

$1,277 to $5,843

208 negotiated rates

$5,843

list

Cesarean section hospital stay, no complications

MS-DRG 788

—

cash

$1,225 to $21,752

53 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 20 lines · metro median $34

$34

cash

$17 to $266

1272 negotiated rates

$127

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 30 lines · metro median $224

$224

cash

$43 to $4,043

6188 negotiated rates

$828

list

Colonoscopy with biopsy

CPT 45380 · lowest of 16 lines · metro median $267

$267

cash

$170 to $5,203

3640 negotiated rates

$989

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 18 lines · metro median $235

$235

cash

$127 to $5,203

3276 negotiated rates

$871

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 14 lines · metro median $8

cash

$4 to $146

1036 negotiated rates

$29

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 4 lines · metro median $10

$10

cash

$5 to $701

392 negotiated rates

$38

list

Electrocardiogram (ECG) with interpretation

CPT 93000 · lowest of 4 lines · metro median $19

$19

cash

$13 to $69

504 negotiated rates

$69

list

Established patient office visit (about 40 minutes)

CPT 99215 · lowest of 6 lines · metro median $55

$62

cash

$52 to $229

624 negotiated rates

$229

list

Family psychotherapy without the patient

CPT 90846 · lowest of 2 lines · metro median $64

$72

cash

$42 to $772

273 negotiated rates

$265

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 6 lines · metro median $225

$225

cash

$90 to $26,286

910 negotiated rates

$834

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 18 lines · metro median $34

$34

cash

$17 to $262

1162 negotiated rates

$127

list

Hip or knee replacement, no major complications

MS-DRG 470

—

cash

$1,225 to $43,760

53 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392

—

cash

$1,000 to $17,686

53 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743

—

cash

$1,225 to $28,147

52 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 12 lines · metro median $178

$178

cash

$117 to $15,567

1911 negotiated rates

$659

list

Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 9 lines · metro median $139

$139

cash

$123 to $39,722

1453 negotiated rates

$513

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · lowest of 8 lines · metro median $212

$212

cash

$188 to $2,391

637 negotiated rates

$787

list

Left heart catheterization

CPT 93452 · lowest of 4 lines · metro median $176

$176

cash

$155 to $14,096

364 negotiated rates

$650

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 24 lines · metro median $20

$20

cash

$6 to $290

1852 negotiated rates

$74

list

Liver function panel

CPT 80076 · lowest of 2 lines · metro median $45

$95

cash

$3 to $350

110 negotiated rates

$350

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 2 lines · metro median $939

$1,462

cash

$327 to $5,413

642 negotiated rates

$5,413

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 18 lines · metro median $569

$934

cash

$224 to $3,462

4494 negotiated rates

$3,459

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 4 lines · metro median $430

$935

cash

$224 to $3,463

1177 negotiated rates

$3,463

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 4 lines · metro median $292

$292

cash

$224 to $3,462

1070 negotiated rates

$1,082

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473

—

cash

$1,225 to $55,384

53 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · metro median $169

$4,786

cash

$235 to $17,727

88 negotiated rates

$17,727

list

New patient office visit (about 30 minutes)

CPT 99203 · lowest of 4 lines · metro median $38

$43

cash

$35 to $159

424 negotiated rates

$159

list

New patient office visit (about 45 minutes)

CPT 99204 · lowest of 4 lines · metro median $64

$72

cash

$60 to $268

424 negotiated rates

$268

list

New patient office visit (about 60 minutes)

CPT 99205 · lowest of 6 lines · metro median $83

$93

cash

$78 to $345

636 negotiated rates

$345

list

PSA test (prostate)

CPT 84153 · lowest of 12 lines · metro median $18

$18

cash

$10 to $237

926 negotiated rates

$67

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 8 lines · metro median $46

$58

cash

$3 to $216

440 negotiated rates

$216

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 82 lines · metro median $22

$22

cash

$20 to $307

4544 negotiated rates

$83

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 8 lines · metro median $137

$137

cash

$86 to $2,176

851 negotiated rates

$508

list

Preventive visit, new patient age 18 to 39

CPT 99385 · lowest of 4 lines · metro median $47

$52

cash

$40 to $192

512 negotiated rates

$192

list

Preventive visit, new patient age 40 to 64

CPT 99386 · lowest of 4 lines · metro median $55

$63

cash

$49 to $233

512 negotiated rates

$233

list

Prostate biopsy

CPT 55700 · lowest of 10 lines · metro median $98

$98

cash

$86 to $2,815

441 negotiated rates

$363

list

Prostate removal (laparoscopic)

CPT 55866 · lowest of 2 lines · metro median $946

$946

cash

$838 to $46,218

91 negotiated rates

$3,504

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 16 lines · metro median $4

cash

$3 to $85

1412 negotiated rates

$15

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 2 lines · metro median $23

$24

cash

$21 to $772

273 negotiated rates

$89

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 2 lines · metro median $36

$36

cash

$32 to $772

273 negotiated rates

$133

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 2 lines · metro median $54

$54

cash

$48 to $772

273 negotiated rates

$201

list

Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 10 lines · metro median $140

$140

cash

$124 to $17,024

1472 negotiated rates

$520

list

Shoulder arthroscopy with decompression

CPT 29826 · lowest of 9 lines · metro median $54

$61

cash

$39 to $68,691

828 negotiated rates

$226

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 8 lines · metro median $75

$75

cash

$66 to $3,734

1274 negotiated rates

$278

list

Spinal fusion (not neck), no complications

MS-DRG 460

—

cash

$1,225 to $82,984

51 negotiated rates

—

list

Spinal injection, lower back, no imaging guidance

CPT 62322 · lowest of 4 lines · metro median $185

$185

cash

$132 to $3,846

182 negotiated rates

$686

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · metro median $733

$5,979

cash

$247 to $22,144

88 negotiated rates

$22,144

list

TSH test (thyroid)

CPT 84443 · lowest of 10 lines · metro median $16

$16

cash

$8 to $340

816 negotiated rates

$61

list

Tonsils and adenoids removal (under age 12)

CPT 42820 · lowest of 2 lines · metro median $304

$304

cash

$165 to $25,739

364 negotiated rates

$1,125

list

Transvaginal ultrasound

CPT 76830 · lowest of 8 lines · metro median $25

$25

cash

$22 to $1,217

1017 negotiated rates

$92

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 4 lines · metro median $93

$93

cash

$82 to $2,910

380 negotiated rates

$344

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 8 lines · metro median $150

$150

cash

$38 to $3,944

2002 negotiated rates

$556

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 10 lines · metro median $177

$177

cash

$89 to $3,944

2093 negotiated rates

$657

list

Urinalysis with microscope

CPT 81001 · lowest of 12 lines · metro median $5

cash

$2 to $135

1302 negotiated rates

$17

list

Vaginal delivery after a previous cesarean

CPT 59610 · lowest of 2 lines · metro median $1,495

$1,495

cash

$1,211 to $5,538

156 negotiated rates

$5,538

list

Vaginal delivery hospital stay, no complications

MS-DRG 807

—

cash

$1,000 to $15,295

53 negotiated rates

—

list

Vaginal delivery with prenatal and postpartum care

CPT 59400 · lowest of 2 lines · metro median $1,429

$1,429

cash

$678 to $5,294

208 negotiated rates

$5,294

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 10 lines · metro median $11

$11

cash

$10 to $1,083

1081 negotiated rates

$42

list

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.

https://www.theorthohospital.com/Uploads/Public/Documents/charge-masters/charge-masters-2024/261483076_the-orthopedic-hospital_standardcharges.csv
The Orthopedic Hospital · parsed · wide v3.0.0 · file dated 2026-04-01 · 999.9 MB · 63709 price rows read · read Nov 2026